[Clinical competence in intensive cardiac care units: from practical needs to training programs].

Since the early 1970s, intensive cardiac care is applied in coronary care units (CCUs), initially developed to treat lethal arrhythmias in patients with acute myocardial infarction. In the last decades, treatments offered within the CCUs have greatly expanded. Thus, these units have been called intensive cardiac care units (ICCUs) to reflect such evolution of care and the different epidemiology of patients admitted (subjects with acute coronary syndromes, acute and advanced heart failure, rhythm disturbances or severe valve dysfunction). At the same time, new drugs have become available but also different diagnostic, interventional and therapeutic procedures have been developed, resulting in better patient treatment and improved outcomes. These new devices require a high degree of specialization and specific skills that not every cardiologist is always used to. Consequently, specific training programs on intensive cardiac care for cardiologists working in ICCUs are clearly warranted. The present paper describes the advanced training programs on intensive cardiac care endorsed by the European Society of Cardiology and the Italian Association of Hospital Cardiologists (ANMCO). Both projects aim at improving current knowledge and skills of intensive cardiologists on specific pharmacologic and technical procedures, extending the competence of trained cardiologists to the management of critically ill cardiac patients, and uniforming the quality of care in any ICCU.